The present invention relates to methods of and apparatus for making a history or record, particularly, but not exclusively, of medical treatments or procedures, and to methods of and apparatus for using the history or record. More particularly, it relates to producing and digitizing a number of images to create a digital library of images, producing and providing a digital library of texts corresponding to the images in the library of images, providing an image from outside the digital library, digitizing it and comparing it to the digital images in the digital library, and selecting from the digital library of texts a text which corresponds to the outside image, and using the selected text to produce at least a portion of a record.
In many fields and technologies it is important to create and maintain a record, or history or narrative, of situations, facts, operations or procedures. Such records are important for achieving repeatability and accuracy, for educational or evaluative purposes, and/or for reconstructive purposes. For example, in industrial production, they may be used to detect deviations from specifications and production standards, and/or they may be used to create a xe2x80x9cstandard operating procedurexe2x80x9d (xe2x80x9cSOPxe2x80x9d). In the legal field, transcripts or records of legal proceedings may be used to revisit or review the propriety of proceedings and decisions. In research or experimental science, laboratory notebooks or journals may reflect and/or evidence results of chemical combinations or hypothesis. In medicine, medical records and transcripts of surgical procedures may be used for diagnosis, to determine subsequent treatments, and/or to determine or assess prognoses. In each of these examples, and in many other instances and fields, records provide a database or library of knowledge, teach, instruct or inform about past practices or products, and/or aid in the detection and elimination of anomalies and inaccuracies.
Making and keeping a record has been, and is, a painstaking process. Typically, it has involved an individual hand writing a description or narrative, which may then be archived or preserved for reference by the individual who created it, or others. Developments in recording technologies, e.g., photography, sound and voice recording and storage, digital storage of information, etc., have somewhat eased the burden of creating a record, but there is room for further improvement.
Turning to the field of medicine, in which the present invention finds particular, but not exclusive, applicability, medical records were typically produced by the care giver writing by hand, for example, in a patient""s chart. More recently, a care giver or physician may speak into a sound recording machine, or dictate, a description of a treatment or procedure. The recording or xe2x80x9ctapexe2x80x9d is then transcribed by others into a written record or chart. Also more recently, photographic records may be used. For example, a surgical procedure may be filmed, and the film may be accompanied by a verbal description dictated or spoken by the surgeon or attending physician while the procedure is taking place. Notwithstanding these advances, problems and inefficiencies remain.
One problem stems from outsourcing dictated medical records, even when such outsourcing is to organizations or people specializing in the transcription of medical records. The dictated item must be communicated to the transcriptionist, and back, and physicians and care givers must review and edit the transcription, leading to inefficiencies in time and handling, and increased costs. Another problem is the time interval or delay between the procedure and the availability of the transcript. This is true even when a physician dictates during a procedure, which itself may interfere with the concentration or performance of the physician. Typically, current medical record procedures still require a physician or surgeon to go to a workstation to dictate a description of a procedure or treatment after it is completed, at least to review a transcript, but in most instances, to dictate a description as well.
There are some attempts to improve the efficiency of producing medical records. For example, there are service providers, e.g., Speech Machines, Inc. and MedQuist, Inc., which specialize in transcribing dictated descriptions of medical treatments. They may use voice or term recognition systems (e.g., Dragon System""s xe2x80x9cNaturally Speaking,xe2x80x9d IBM""s xe2x80x9cViaVoicexe2x80x9d and Lernout and Hauspie""s xe2x80x9cVoiceXpressxe2x80x9d) wherein a vocal term or phrase is recognized by a computer which then converts it into a word-processing result. U.S. Pat. No. 6,031,526 discloses a system wherein generating electronic and printed medical records provides automatic integration of captured video still images and voice dictated information concerning the image, and wherein a voice recognition module allows the system to respond to voice commands and automatically transcribe the dictated text into a word processing document. Another, generally similar example of such systems is that provided by cMore Medical Solutions, Inc. of Minneapolis, Minn. Although efficiency of making a record may be increased, there are still transmission and handling delays, even when use is made of browser or internet-based systems.
One way to relieve physicians"" dictation burden would be to film or photograph a treatment or surgical procedure and use the recorded images to trigger a descriptive text. Such a solution would likely involve a computer or computers. U.S. Pat. No. 4,996,707 (O""Malley et al.) discloses a computer system having the capability to receive and store graphic images which might be useful in such a solution. The system includes software that can digitize images, enabling them to be stored in memory and then accessed and used for various purposes, including identification, printing, or converting the digitized images to speech using a xe2x80x9ctext-to-speechxe2x80x9d module. There is no disclosure or suggestion of digitizing a large number of images to create a digital library of images, providing an image from outside the digital library, digitizing it and comparing it to the digital images in the digital library, and providing for the production of a descriptive text associated with the image from outside the digital library.
Computers and storage and manipulation of data using computers hold promise for improving medical record creation, record keeping and use of stored medical records. For example, U.S. Pat. No. 5,050,220 involves an optical fingerprint correlator wherein a fingerprint is digitized, and then may be compared to a database of fingerprints to try to find a match. Such a correlator could be adapted to identify a patient, pull up the patient""s medical record, and compare a current or recent diagnostic image (e.g., an MRI image) to the record. U.S. Pat. No. 5,031,228 discloses another image recognition system and method for identifying a pattern in images, and U.S. Pat. No. 5,668,897 discloses a method and apparatus for imaging and image processing, including digitizing an image and comparing the digitized image against a codebook of stored digital images. None of these patents discloses using an image to select or create a text describing an image.
The use of microprocessors, computers and computer management of data, including images, in the field of medicine is reflected in U.S. Pat. Nos. 5,241,472; 5,261,404; 5,740,802; 5,951,571; 5,961,456 and 6,024,695, the disclosures of which patents are incorporated herein by reference. Typically, the systems and methods disclosed in these patents involve obtaining images, digitizing the images and storing and/or manipulating or using the images, e.g., in U.S. Pat. No. 5,241,472 to create a text file. In U.S. Pat. No. 5,951,571 a computer is used to access a data storage unit containing previously acquired and digitally stored images of a patient. U.S. Pat. No. 5,961,456 is directed to a system and method for using current actual images and computer generated reference images, and the U.S. Pat. Nos. 5,261,404 and 6,024,695 patents use computer technologies to use images to position or guide surgical procedures. The U.S. Pat. No. 5,740,802 patent involves interactive computer generated models obtained from medical diagnostic imaging data to allow a surgeon to view internal and external patient structures and their relation to adjust the surgery accordingly. None of these patents discloses or suggests the use of the disclosed technologies to facilitate dictation, i.e., to help a physician create a medical record describing an administered treatment or procedure by using an image drawn from the treatment or procedure to trigger or select a text descriptive of the image, wherein the text then becomes at least part of a medical record.
U.S. Pat. Nos. 5,704,371 and 6,026,363 disclose a medical history documentation system and method which may involve a microprocessor to collect data and down load it to a computer which may store and process the data to provide a patient history text. There is no disclosure of using images to provoke the selection of a text corresponding to the image, wherein the selected text may become the record, or portion of the record, of a medical treatment or surgical procedure.
Notwithstanding the advances represented by the above mentioned technology and patents, it would be advantageous if there were a method and apparatus for more efficiently and accurately making a history or record, particularly, but not exclusively, a medical record.
In one embodiment, the present invention provides methods and apparatus for making a history or record, particularly, but not exclusively, of a medical treatment or surgical procedure.
In one embodiment, the present invention relates to producing and digitizing a number of images to create a digital library of images, providing an image from outside the digital library, digitizing it and comparing it to the digital images in the digital library, and producing a text associated with the image from outside the digital library.
In one embodiment, the present invention comprises a visual input device, a processor, a visual output device, and a transmission system linking the input device, the processor and the output device.
In one embodiment, the present invention relates to the capture, recognition and manipulation of data.
In one embodiment, the present invention relates to the capture, recognition and manipulation of data, particularly data concerning medical treatment, wherein the treatment may be broken down into a series of steps, and wherein each step may be described by standard language understood by one skilled in the art. This feature of the present invention is well-suited to use in surgical procedures, wherein any one procedure may be accomplished in one of usually several or so standard or routine ways, wherein any one procedure may be broken down into steps or milestones, and wherein any one procedure usually involves encountering the same or similar physical structures.
An advantage of the present invention is that it facilitates creating a record, particularly, but not exclusively, a medical record.
In one embodiment, the present invention relates to producing and digitizing a number of images, related to a medical treatment, particularly a surgical procedure, to create a digital library of images, providing an image from outside the digital library, digitizing it and comparing it to the digital images in the digital library, and producing a text associated with the image from outside the digital library. In some embodiments, an image of an unusual, a typical and/or anomalous medical condition or situation may provoke, trigger or provide a xe2x80x9cblankxe2x80x9d text to be filled in later by the treating person. An advantage is better coordination of procedures and respective outcomes, as well as improving the time it takes for comparative or analytical information to become available. In some embodiments, the image from outside the digital library may be a real time image.
A feature of the present invention is image recognition, wherein a collection of images is available, each having an associated descriptive text, and wherein an image not in the collection is compared to images in the collection to find a comparable or matching image, and associated text. The collection of images may be created by accumulating images originally not in the collection.
Another feature of the present invention is providing a library of descriptions or texts, each associated, related to and/or describing a structure, step or quality depicted or captured as an image. In some embodiments, the structure, step or quality is an aspect of a medical treatment or surgical procedure.
Another feature of the present invention is providing coordination of procedures and outcomes, e.g., the outcome of a medical treatment may be compared to outcomes of similar procedures, anomalies or abnormalities may be compared and/or identified, a record of a procedure may be available for consideration more quickly, etc.
In one embodiment of the method and apparatus of the present invention, a live or real-time image obtained during a surgical procedure is compared to stored images of previous surgical procedures to find a stored image similar or substantially identical to the live image, whereupon a script or text describing the live image is produced.
In some embodiments, the method of the present invention involves creating a collection or library of images drawn from surgical procedures, e.g., laparoscopic gallbladder procedures, cholecystectomy, hernia procedures, etc., wherein the individual images comprise pictorial representations of anatomy or structures encountered and steps undertaken during the procedures. In some embodiments, the collection of images may be sorted or indexed into sets or groups, wherein a set or group may be comprised of any number of generally similar images depicting a step or action which is typically common to a selected procedure, e.g., a step in a laparoscopic gallbladder procedure.
In one embodiment, the present invention encompasses breaking a surgical procedure into a series of steps, capturing or representing each step in an image, each image depicting the step and structures and qualities associated with the step, digitizing the images, and creating a text respectively descriptive of a step and images of that step, wherein the text comprises standard language understood by one skilled in the art, and may be selected, without substantial change, to describe the similar step of another generally similar surgical procedure, the text selection being accomplished on the basis of comparing images from the generally similar surgical procedure to the previously acquired images.
In one embodiment, the present invention relates to producing a number of digital images to create a digital library of images, providing an image from outside the digital library, digitizing it (if it is not already digital) and comparing it to the digital images in the digital library, and producing a text associated with the image from outside the digital library, wherein the digital images and text may be considered data and may be analyzed and/or manipulated to provide likely or actual: diagnostic outcome information; a classification or sort of procedures by type; possible therapeutic, corrective or repair steps; and a recommendation of optional, and/or the optimal, therapeutic, corrective or repair steps. In one embodiment, the present invention may provide for statistical analysis of subject procedures and outcomes, for example, surgical procedures, whereby the optimum or best step or action within a given procedure may be identified.
In one embodiment of the present invention, data may be accumulated, analyzed and reported.
In one embodiment, the present invention relates to methods and apparatus for viewing and taking an image or picture of a number of objects or situations, processing the images, including digitizing and storing them and creating a text describing each of them, viewing and taking another image or picture, processing the another image, including digitizing and storing it, and selecting one of the texts which corresponds to the another image.
An advantage of the present invention is the creation and use of a world-wide network of procedural information, including, but not limited to medical and/or surgical information, wherein the information may be accessed by those engaged in similar procedures and/or wherein the information may evolve, e.g., the data comprising the information may increase, both in number and sophistication.
Another advantage of the methods and apparatus of the present invention is that they may be used to create an xe2x80x9cearly warningxe2x80x9d system wherein a real-time image is compared to a library of images which includes images of anomalous, abnormal and/or dangerous structures, situations and/or qualities and, if a similarity is detected, a warning or alert is provided. In one embodiment, the present invention takes advantage of the routine, repetitive or common steps typical of a given procedure, for example, a surgical procedure, to provide for the early warning system, and/or to provide for a predictive and/or educational system, wherein a accessible and/or searchable database comprising a collection of images and texts to provided for consideration before undertaking a procedure.
Other features and advantages of methods and apparatus of the present invention will become more fully apparent and understood with reference to the accompanying description, drawings and claims.